SPONSORED STUDENT
–
WAIVER FORM
TRU-OL Student Services
805 TRU Way,
Kamloops, BC V2C 0C8
truopen.ca
Email: student@tru.ca
Fax: 250-852-6405
SURNAME (legal)
FIRST NAME (legal) FULL MIDDLE NAME(S) (legal)
The AGENCY/GROUP named above
confirms sponsorship of this STUDENT:
AGENCY/GROUP
PROVINCE / STATE
PRIMARY TELEPHONE NUMBER
POSTAL CODE / ZIP CODE
EMAIL ADDRESS (print clearly)
CITY / TOWN / VILLAGE
SPONSOR
ATTENTION/CONTACT
TRU-OL STUDENT NUMBER
PROGRAM (if sponsoring entire program)
STUDENT’S SIGNATURE DATE
MAILING ADDRESS (include suite number if applicable)
FAX NUMBER
PROVINCE / STATE
HOME TELEPHONE
POSTAL CODE / ZIP CODE
DATE OF BIRTH (mm/dd/year)
MAILING ADDRESS (include suite number if applicable)
CITY / TOWN / VILLAGE
EMAIL ADDRESS (print clearly)
COURSE NUMBER COURSE NAME COURSE NUMBER COURSE NAME
COURSE NUMBER COURSE NAMECOURSE NUMBER COURSE NAME
BUSINESS TELEPHONE
COURSES
DATES (For this period of time)
to
Program Application Fee $ _________________________ Official Transcript $ ____________________________
Tuition (including administration, technology and miscellaneous fees) $ ________________________________
Textbooks $ _______________________________________ Total Sponsored $ ____________________________
COSTS The sponsor agrees the costs they are responsible for include: (Check list please)
AUTHORIZED SPONSOR SIGNATURE TITLE/POSITION
MMM-DD-YY
(
E.G. SEP-01-17
)
MMM-DD-YY
(
E.G. SEP-01-17
)
TRU CANNOT RELEASE ANY INFORMATION UNLESS THE STUDENT HAS SIGNED THIS WAIVER. MC123131
•
10/26/17
I,
, do hereby authorize TRU to release any information regarding aendance,
progress and grades, upon request, to the above named sponsor.
T
“T” FOLLOWED BY EIGHT DIGITS
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signature
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